绘制性和性别少数群体医疗保健差异的动态复杂性:一种系统思维方法
Braveheart Gillani1, Dana M Prince1, Meagan Ray-Novak1
1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA.
性和性别少数群体 (SGM) 个人面临着严重的医疗保健接入障碍,原因是耻辱和偏见. 社区主导的,支持SGM的护理对于改善健康公平和与服务的连接至关重要.
科学领域:
- 健康差距 研究 研究 研究 研究
- 复杂系统科学 (CSS) 是指复杂系统的科学.
- 基于社区的参与式研究
背景情况:
- 性别和性别少数群体 (SGM) 的人群与异性恋和异性恋人群相比,经历了显著的健康差异.
- 对SGM群体获得医疗保健的障碍包括社会耻辱,提供者偏见,歧视和财务限制.
- 解决这些差异对于改善健康结果和确保公平护理至关重要.
研究的目的:
- 了解和可视化阻碍和促进SGM个体在整个生命过程中参与医疗保健的障碍和促进者.
- 确定影响SGM医疗连接的核心结构,关系和反机制.
- 为制定有针对性的干预措施提供信息,以减少SGM健康差异.
主要方法:
- 利用基于社区的系统动态方法.
- 与各种SGM社区成员 (年轻人,老年人,跨性别者和性别扩展型个人) 进行了小组建模会议.
- 开发了因果循环图和元模型来表示集体体验.
主要成果:
- 确定了SGM个体医疗保健的广泛,动态和不断变化的结构性障碍.
- 社会/结构性耻辱,提供者偏见和病理化成为重要的生命过程障碍.
- 社区主导的干预和以SGM为重点的整体医疗保健被确定为关键促进者.
结论:
- 由于普遍存在的结构和社会障碍,SGM医疗保健的获取受到阻碍.
- 肯定SGM,对文化敏感的医疗保健环境对于改善参与是必不可少的.
- CSS方法对于开发有效的干预措施来减少SGM健康差异至关重要.
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